Saturday, April 14, 2007
A note on paying for universal health care
My favorite lefty blogger, Ezra Klein, has written a thoughtful article about a new proposal to spend less money and still get universal health care. Yes, it is a little long on the apologies to his progressive constituency -- he commits the apostasy of suggesting that people would use health care benefits less wastefully if they shouldered a significant proportion of their own expenses -- but it certainly heads in the right direction. I may write more once I've chewed on the links.
5 Comments:
By 
, at
Sat Apr 14, 07:44:00 PM:
I have to disagree with Ezra on a couple points.
He concludes that because we pay more for a unit of health care than other countries, "we're getting gouged." The better interpretation is that gross restrictions in other nations drive up prices at home. It does not follow that it is in our best interest to also misbehave.
I also don't like the argument that "the government can use its massive market share to bargain down prices and advocate for [Americans] interests." The government does this for the VA. The result is that new drugs aren't brought into the system for several years. And lower prices are paid for by significantly reduced competition. Which interests are supposed to be served?
I will agree that there should be more sensible consideration of treatments so that required things like insulin for diabetics are not treated the same as more frivolous things like viagra.
As an extra: here's a good EconTalk podcast with John Cogan. It hits on a lot of the same topics, and even the RAND study in particular (I think).
By 
SR, at
Sat Apr 14, 08:15:00 PM:
Same old......
Keep trying Ezra
Spending less on healthcare will get you less healthcare. Basic economics. Ezra is arguing that we are spending more, but getting "gouged"because the results aren't that improved. This can be translated:
We are spending too much and for it getting more medical care than we need because if we needed this much it would show up in the results.
As "progressives" always do Ezra then leaps to the conclusion that central planning will come up with the right amount of care for the right price. Never has, never will.
Why should anybody care if some patients spend too much on healthcare? We want to solve the problem of patients who can't afford to spend ENOUGH to get satisfactory results. Jawboning down the costs by National Health (I so want to use the N*zi word here, but look what happened to Imus) regulators will only result in shortages.
Here's a compromise: let the system continue, set a "National Health Formulary" for those drugs (whoever decides what they are) that are "cost effective." Get reduced prices for generic versions.
Let them be dispensed at national healthcare clinics staffed by providers recently out of traiinng who perform 2 yrs of national service, as well as episodic volunteer providers (most of the rest of us would gladly volunteer some time).
These healthcare clinics will have long waiting lines, but so be it. Some of the 45 million will decide that they should pay for their healthcare at market rates like they should.
Ezra looks way too young and inexperienced to be making policy concerning something he has likely had little experience with.
By , at
Sat Apr 14, 11:56:00 PM:
Like most leftists, he concludes that because US healthcare is a large and expensive chunk of GDP there's something wrong with it. His error, IMO, is to forget the quality of what you're buying. If you want the best you have to pay for it, and Americans are wealthy enough to afford it. Why, exactly, leftists advocate we should do what less wealthy European countries do is beyond me.
There are no waits for essential diagnostic tools like MRIs because you have only one for your whole city. The money and prestige of US medical practice bring the best and brightest into the field rather than scrubs. Doctors have an incentive to actually see patients, not like the UK where doctors will often see only a few patients each day because, like the DMV, you can't fire them for lousy service. If you die while waiting for your appointment that's just too bad, the savings from not treating you are an intentional part of the system. Americans don't go for that kind of morality. American medical R&D is the best in the world. Foreigners with money come *here* for their medical care. Heck, even Canadians do.
By Purple Avenger, at
Sun Apr 15, 07:48:00 AM:
not like the UK where doctors will often see only a few patients each day
A hospital in the UK was fined last year for being too efficient.
The government said X-disease patients must wait Y-weeks/months for treatment, and they were processing them a lot faster because they simply were able to.
Big flap and scandal over that. The Guardian of course took the position that the govt was right and you can't just have care givers running around implementing efficiency on their own and backed the punishments and fines.
My dad used to say: "No good deed goes unpunished".
By , at
Mon Apr 16, 10:42:00 AM:
Who idea of UNIVERSAL HEALTH CARE is it? If its HILLARY CLINTONS then it mean take yourself to the witch doctor and OOOO EEE OOO AHH AHHH BING BANG WALLA WALLA BING BANG and ITS JUST COMMON COLD GO HOME AND MAKE SOME CHICKEN SOUP
